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PubMed1977

Correlation between plasma chlorpromazine and its metabolites and clinical ratings in patients with acute relapse of schizophrenic and paranoid psychosis.

Nine patients diagnosed as having acute schizophrenic psychosis were treated with chlorpromazine. Their clinical response to drug treatment was measured by the use of a clinical rating scale developed from the Present State Examination, and a nurses rating scale. Plasma levels of chlorpromazine (CPZ), 7-hydroxychlorpromazine (7OHCPZ), monodesmethylchlorpromazine (NOR1CPZ) and chlorpromazine sulphoxide (SOCPZ), were monitored during the period of hospital treatment. Correlations were made between the increase in plasma levels of drug or metabolites and improvement in the different PSE scores. These showed that the most significant correlations occurred when symptoms with high diagnostic significance for schizophrenia (Group 1) and symptoms rating perceptual disorders (P) were correlated with plasma 7OHCPZ levels in plasma samples taken before the first morning dose of CPZ. The ration of 7OHCPZ to CPZ in these samples increased significantly as clinical ratings improved, this correlation being most highly significant against the Group 1 and P scores. The ratio of 7OHPCZ to SOCPZ increased significantly only in the case of Group 1 and P scores. This indicates a preferential shift of CPZ metabolism towards the formation of the active 7OHCPZ during the period of clinical improvement.

Acute Disease↗

PubMed1989

[A study on factors related to daily activities of post myocardial infarction patients].

The purpose of this study was to identify factors related to daily activities of post myocardial infarction patients. Data were collected from Aug. 1 to Aug. 31, 1988 through an interview schedule lasting for about 30-60 minutes by the investigators. Tools for this study were a daily activities scale and a subjective physical symptom scale developed by the researchers, and Zung's self rating depression scale. The subjects were 45 men 18 women post myocardial infarction patients who were receiving follow up care at SNU Hospital. The data were analyzed by percentage, mean, t-test, ANOVA, the Pearson moment Correlation Coefficient test, and Cronbach's a reliability test. The results were as follows. 1. Reliability of the daily activities scale was 0.91 by Cronbach's a. In the daily activities scale, items about transfer, exercise, and job related activities were most highly rated as meaningful to the post myocardial infarction patients. 2. The average daily activities score of these patients was 3.30 (maximum point:4) all scores were high except for exercise and job related activities. 3. There was a significant difference in daily activities according to sex; men had a higher daily activities score than women (T=2.32, P less than 0.05). 4. There was a significant difference in daily activities according to job status. Subjects having a job had a higher daily activities score. 5. The lower the depression score, the higher the daily activities score (gamma=-0.5748, P less than 0.05). 6. The lower the subjective physical symptoms score, the higher the daily activities score (gamma=-0.6015, P less than 0.05).

Activities of Daily Living↗

PubMed1977

Assessing depressive symptoms in five psychiatric populations: a validation study.

Data from five psychiatric populations and a community sample are presented on the CES-D, 20-item self-report depression symptom scale developed by the Center for Epidemiologic Studies. Results show that the scale is a sensitive tool for detecting depressive symptoms and change in symptoms over time in psychiatric populations, and that it agrees quite well with more lengthy self-report scales used in clinical studies and with clinician interview ratings. Although a symptom scale cannot differentiate between diagnositc groups, the CES-D has demonstrated its validity as a screening tool for detecting depressive symptoms in psychiatric populations.

Adolescent↗

PubMed1988

Patient satisfaction with primary medical care. Evaluation of sociodemographic and predispositional factors.

As patient satisfaction has been demonstrated to influence certain health-related behaviors (e.g., compliance with medical regimens and use of medical services), research has attempted to identify its key determinants. Although the influence of patient characteristics often has been studied, attention has been focused on sociodemographic characteristics (e.g., age and sex) rather than attitudinal or situational factors (e.g., confidence in the medical care system and feelings of internal control) that may predispose one toward satisfaction with care received. Data to test the relative importance of these types of determinants were collected in a general household survey of 400 persons. The patient satisfaction scale developed and tested by Roghmann and his colleagues using nonmetric multidimensional scaling was used. Multiple regression analysis was performed on the data. Results show that certain predispositional factors (confidence in the community's medical care system, having a regular source of care, and being satisfied with life in general) are more important predictors of patient satisfaction than patient's age, sex, race, educational attainment, or income.

Consumer Behavior↗

PubMed1988

Predicting repetition of deliberate self-harm: a review of the literature in the light of a current study.

Three hundred and sixty-five patients exhibiting deliberate self-harm (DSH) were rated for DSH repetition on the six-item predictive scale of Buglass & Horton and on a five-point predictive scale developed from a previous study by the author. The Buglass & Horton scale was more sensitive and more specific overall and for female patients, but the five-point scale predicted better for males, especially those aged under 35. The results are discussed in relation to previous work on the prediction of DSH repetition.

Adult↗

PubMed1986

Change in adaptive behaviour of severely and profoundly mentally handicapped adults in different residential settings.

A demographic sample of 28 severely and profoundly mentally handicapped adults with a mental age of four years and below were assessed on Part 1 of the Adaptive Behavior Scale (ABS) at three points 18 months apart. The Griffiths Mental Development Scales and Reynell Developmental Language Scales were also conducted at the first and last assessment points. The subjects were resident in either a small community-based home, the parental home or other residential institutions. The small-home group showed the greatest adaptive behaviour change particularly in the areas of independent functioning, domestic skills and self-direction and on the scale total. Although reservations are expressed on the accuracy of assessment, the ABS data and the comparative result received some validation from the mental age and language assessments. Gains were independent of subject characteristics. The study adds to the literature showing adaptive behaviour gains arising from transfer from institutional to more normal residential environments. However, in attributing the results found to the general characteristics of the residential settings, the explicit programming emphasis of the small-home service should not be overlooked.

Adolescent↗

PubMed1980

Alprazolam, a new type anxiolytic in neurotic patients. A pilot study.

Alprazolam is a new type triazolobenzodiazepine anxiolytic agent. 115 neurotic patients were treated with alprazolam for 4 weeks in an open label study. The daily dose of alprazolam ranged from 0.4 to 3.2 mg (average: 1.4 mg). 73% of the subjects experienced a slight to remarkable improvement. A particularly high improvement rate was observed in patients with initially severe sleep disturbances. No serious side effects were noted. Comparative characteristics of neurotic patients with insomnia (insomnia neurotic patients) were investigated and the validity of the PNRS-D (Psychoneurotic Rating Scale developed by the authors) in comparison with the Hamilton Anxiety Rating Scale is discussed.

Adult↗

PubMed1989

A new approach to the measurement of cognitive deficits in dementia.

Although scales developed for use with the general population and those developed for use with patients with dementia provide important assessment tools, there are certain questions that might best be answered by cognitive scales that span the range of difficulty from that of the healthy older adult through that of the patient with mild to moderate dementia. To address this need, six cognitive scales are being constructed by using data from both healthy older adult and probable Alzheimer populations in item development and analysis. It is anticipated that these scales will be useful in addressing questions about patterns of deficits in dementias of different etiologies, progression or improvement of function in demented patients, and relationships between cognition and other variables in cognitively impaired patients.

Aged↗

PubMed1990

Impact of the Medicare fee schedule on payments to physicians.

Beginning in 1992, the Medicare program will pay physicians by the Medicare Fee Schedule, a system of geographically adjusted standardized payment rates based in part on the Resource-Based Relative Value Scale developed by Hsaio et al and in part on current Medicare payments. In our simulations of the Medicare Fee Schedule, we find that (1) redistributions of Medicare-allowed charges across specialities will be substantial but approximately only half the size projected by Hsaio, (2) there will be large redistributions among geographic areas that tend to compound the specialty redistributions, and (3) there will be wide variation within specialties as to how individual providers are affected. The majority of the redistributive impact of the Medicare Fee Schedule is attributable to implementation of a geographically adjusted system of standardized payments rather than to the particular work values developed by Hsiao et al in the Resource-Based Relative Value Scale.

Costs and Cost Analysis↗

PubMed1989

Development of an inexpensive and rapid two site microenzyme linked immunosorbent assay kit for human alpha fetoprotein.

Laboratory scale development of a two site micro enzyme linked immuno assay kit is described. The kit comprises rabbit anti human alphafetoprotein (AFP), anti human AFP IgG peroxidase conjugate and standard AFP. All the above reagents were prepared in the laboratory. The kit is eminently suitable for early screening of blood sample of pregnant women for neural tube defects of their fetuses and for the quantitation of AFP as a tumor marker. The assay kit was used to determine AFP in 76 sera from women at different stages of pregnancy. During 1st trimester AFP level was 18 to 119 ng/ml, during 2nd trimester the concentration varied from 85 to 302 ng/ml and during 3rd from 103 to 580 ng/ml. No evidence for maternal antibody to AFP was found. The above data agree with AFP level in pregnant women reported by earlier workers, using RIA or ELISA. The present ELISA kit would hopefully be much cheaper than internationally available ELISA kits for human AFP.

Enzyme-Linked Immunosorbent Assay↗

PubMed1990

Developmental delay in congenital myotonic dystrophy after neonatal intensive care.

Six infants with congenital myotonic dystrophy survived after neonatal intensive care. In later childhood they were assessed by the Griffiths Mental Development Scales: five children were functioning in the mildly handicapped to borderline range of development (DQ 64.0 to 79.0) and the remaining child was severely delayed in development (DQ 33.0). The five children with higher DQ values had a history of ventilatory support of 30 days or less after birth. By contrast, the remaining child with the lowest DQ value had been ventilated for 43 days. This study provides further evidence that prolonged ventilation after birth has prognostic significance in identifying severely affected cases with congenital myotonic dystrophy.

Child, Preschool↗

PubMed1990

[A study of factors influencing the state of adaptation of hemiplegic patients].

The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress, which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent variables in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intervening variables. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject: first, at the pre-discharge period and at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are: 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS (self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list (ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, one way ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre-discharge state. Psychologically, the average degree of depression at follow up was within normal range of depression.(ABSTRACT TRUNCATED AT 400 WORDS)

Activities of Daily Living↗

PubMed1978

A diagnostic interview: the schedule for affective disorders and schizophrenia.

The Schedule for Affective Disorders and Schizophrenia (SADS) was developed to reduce information variance in both the descriptive and diagnostic evaluation of a subject. The SADS is unique among rating scales in that it provides for (1) a detailed description of the features of the current episodes of illness when they were at their most severe; (2) a description of the level of severity of manifestations of major dimensions of psychopathology during the week preceding the evaluation, which can then be used as a measure of change; (3) a progression of questions and criteria, which provides information for making diagnoses; and (4) a detailed description of past psychopathology and functioning relevant to an evaluation of diagnosis, prognosis, and overall severity of disturbance. This article reports on initial scale development and reliability studies of the items and the scale scores.

Bipolar Disorder↗

PubMed1988

Early parental loss and development of adult psychopathology.

We assessed the effect of parental loss during childhood on the development of psychopathology in 90 adults. The subjects with a history of adult psychopathology (PATH group), in comparison with subjects with no history of a psychiatric disorder (NO PATH group), had poorer quality of childhood home life and personal adaptation subsequent to parental loss as assessed by the Home Life and Personal Adaptation (HAPA) scale developed by us. Total HAPA scale scores were the single most powerful predictor of adult psychopathology, accounting for correct prediction of adult psychopathology in 80% (72/90) of the subjects. The PATH subjects had significantly increased plasma levels of cortisol and beta-endorphin immunoreactivity. Moreover, cortisol and adrenocorticotropic hormone levels significantly correlated with total HAPA scores. First-degree family history of psychiatric disorders, age at loss, and parental vs maternal loss were not significantly different between PATH and NO PATH subjects. We conclude that the quality of home life subsequent to early parental loss is critically related to the development of adult psychopathology. The hypothesis that early trauma results in enduring neuroendocrine alterations in hypothalamic-pituitary-adrenal axis function is examined.

Adaptation, Psychological↗

PubMed1990

[Development of a scale to measure the self concept of cesarean section mothers].

Recently, the rate of cesarean section in Korea has been increasing. The results of several previous studies in foreign countries on the emotional responses of cesarean section mothers showed that they might experience difficulties in the mother-infant interaction due to fatigue, lack of early mother-infant interaction, disappointments, anger, feelings of loss of control, and other factors. Human behavior is said to be determined by one's self concept, and self concept is influenced by both internal and external environmental factors. A scale to measure the self concept of cesarean section mothers was needed in order to identify those who might have difficulties in the mother-infant interactions in future. The purposes of this study were to develop a measuring scale, and to test its reliability and validity. The process of this study was as follows. A structured interview was done with 50 cesarean section and vaginal delivery mothers to find their state of emotional reaction after giving birth to their babies. Based on the results of the interviews, a 50 items Likert scale was developed. The self concept of 268 cesarean section and vaginal delivery mothers who were hospitalized at six hospital in seoul were measured, during the period between Feb. 1 and April 30. Reviewing the discriminating power of each item by means of crosstabulation, ten items were selected for the final scale. The reliability and validity of this ten item scale were tested by Cronbach's alpha and t-test, using spss pc + package. The results of this study and recommendation are as follows. 1. The ten selected items were as follows. I feel pains in my breast. (-) I have a good appetite now. (+) I feel pains in my flank. (-) I feel fine now. (+) My body seems to have returned to its prepregnant state. (+) Thinking of the delivery process, I feel sorry. (-) I want to hold my baby in my arms. (+) I want to keep my own life, even if I became a mother. (-) I want to delegate the care of the baby to my mother/mother in law. (-) I think baby is my alter ege. (+) 2. The reliability of this scale was tested by Cronbach's alpha, and the coefficient of this scale was .8066. 3. The construct validity of this scale was tested by means of known group methods. The value of self concept for cesarean section mother was significantly lower than for vaginal delivery mothers (t = -5.51, df = 266, p = 0.007).(ABSTRACT TRUNCATED AT 400 WORDS)

Cesarean Section↗

PubMed1989

Validities of the Physical Estimation Scale in predicting running times.

Two studies were conducted with the purpose of examining the validity of the 12-item Physical Estimation Scale, developed by Safrit and Wood (1985), as a predictor of running performance. Physical Estimation Scale scores were not significantly related to running time at the 5-mi. distance but were significantly correlated with predicted and actual marathon finishing times.

Adult↗

PubMed1988

The experience and meta-experience of mood.

Mood experience is comprised of at least two elements: the direct experience of the mood and a meta-level of experience that consists of thoughts and feelings about the mood. In Study 1, a two-dimensional structure for the direct experience of mood (Watson & Tellegen, 1985) was tested for its fit to the responses of 1,572 subjects who each completed one of three different mood scales, including a brief scale developed to assist future research. The Watson and Tellegen structure was supported across all three scales. In Study 2, meta-mood experience was conceptualized as the product of a mood regulatory process that monitors, evaluates, and at times changes mood. A scale to measure meta-mood experience was administered to 160 participants along with the brief mood scale. People's levels on the meta-mood dimensions were found to differ across moods. Meta-mood experiences may also constitute an important part of the phenomenology of the personal experience of mood.

Adult↗

PubMed1992

[Development of a scale for workers' coping behavior: its reliability and validity].

The purpose of this study is to develop a scale for measuring coping with job stressors. Stress process and coping function provide the theoretical framework. Coping is conceptualized as situation-specific behavior. We measure episodic coping, that is, the strategies that individuals actually use in coping with a particular situation. First, a preliminary scale, was prepared. It contained 39 coping behaviors with job stressor which were based on an open-ended pilot study. Next, factor analysis was conducted in order to identify the structure of the scale. Subjects of this study were 649 male employees and 91 female employees of a in manufacturing firm and research and development institute. By occupation they were comprised of 383 professionals, 99 technicians, 96 clerks, 104 miscellaneous workers and 58 of unknown occupation. Seven items in the preliminary scale were omitted because of their psychometrical properties. Finally, factor analysis showed three factors in the scale: positive action and cognition (11 items), avoidant action and cognition (10 items), and symptom management (11 items). The coping scale showed high conceptual validity and reliability.

Adaptation, Psychological↗